How to Prevent Dementia – by Dr. Richard Restak
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We’ve written about this topic here, we know. But there’s a lot more we can do to be on guard against, and pre-emptively strengthen ourselves against, dementia.
The author, a neurologist, takes us on a detailed exploration of dementia in general, with a strong focus on Alzheimer’s in particular, as that accounts for more than half of all dementia cases.
But what if you can’t avoid it? It could be that with the wrong genes and some other factor(s) outside of your control, it will get you if something else doesn’t get you first.
Rather than scaremongering, Dr. Restak tackles this head-on too, and discusses how symptoms can be managed, to make the illness less anxiety-inducing, and look to maintain quality of life as much as possible.
The style of the book is… it reads a lot like an essay compilation. Good essays, then organized and arranged in a sensible order for reading, but distinct self-contained pieces. There are ten or eleven chapters (depending on how we count them), each divided into few or many sections. All this makes for:
- A very “read a bit now and a bit later and a bit the next day” book, if you like
- A feeling of a very quick pace, if you prefer to sit down and read it in one go
Either way, it’s a very informative read.
Bottom line: if you’d like to better understand the many-headed beast that is dementia, this book gives a far more comprehensive overview than we could here, and also explains the prophylactic interventions available.
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Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm
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In an episode of ABC’s Four Corners this week, the use of spinal cord stimulators for chronic back pain was brought into question.
Spinal cord stimulators are devices implanted surgically which deliver electric impulses directly to the spinal cord. They’ve been used to treat people with chronic pain since the 1960s.
Their design has changed significantly over time. Early models required an external generator and invasive surgery to implant them. Current devices are fully implantable, rechargeable and can deliver a variety of electrical signals.
However, despite their long history, rigorous experimental research to test the effectiveness of spinal cord stimulators has only been conducted this century. The findings don’t support their use for treating chronic pain. In fact, data points to a significant risk of harm.
What does the evidence say?
One of the first studies used to support the effectiveness of spinal cord stimulators was published in 2005. This study looked at patients who didn’t get relief from initial spinal surgery and compared implantation of a spinal cord stimulator to a repeat of the spinal surgery.
Although it found spinal cord stimulation was the more effective intervention for chronic back pain, the fact this study compared the device to something that had already failed once is an obvious limitation.
Later studies provided more useful evidence. They compared spinal cord stimulation to non-surgical treatments or placebo devices (for example, deactivated spinal cord stimulators).
A 2023 Cochrane review of the published comparative studies found nearly all studies were restricted to short-term outcomes (weeks). And while some studies appeared to show better pain relief with active spinal cord stimulation, the benefits were small, and the evidence was uncertain.
Only one high-quality study compared spinal cord stimulation to placebo up to six months, and it showed no benefit. The review concluded the data doesn’t support the use of spinal cord stimulation for people with back pain.
What about the harms?
The experimental studies often had small numbers of participants, making any estimate of the harms of spinal cord stimulation difficult. So we need to look to other sources.
A review of adverse events reported to Australia’s Therapeutic Goods Administration found the harms can be serious. Of the 520 events reported between 2012 and 2019, 79% were considered “severe” and 13% were “life threatening”.
We don’t know exactly how many spinal cord stimulators were implanted during this period, however this surgery is done reasonably widely in Australia, particularly in the private and workers compensation sectors. In 2023, health insurance data showed more than 1,300 spinal cord stimulator procedures were carried out around the country.
In the review, around half the reported harms were due to a malfunction of the device itself (for example, fracture of the electrical lead, or the lead moved to the wrong spot in the body). The other half involved declines in people’s health such as unexplained increased pain, infection, and tears in the lining around the spinal cord.
More than 80% of the harms required at least one surgery to correct the problem. The same study reported four out of every ten spinal cord stimulators implanted were being removed.
Chronic back pain can be debilitating. CGN089/Shutterstock High costs
The cost here is considerable, with the devices alone costing tens of thousands of dollars. Adding associated hospital and medical costs, the total cost for a single procedure averages more than $A50,000. With many patients undergoing multiple repeat procedures, it’s not unusual for costs to be measured in hundreds of thousands of dollars.
Rebates from Medicare, private health funds and other insurance schemes may go towards this total, along with out-of-pocket contributions.
Insurers are uncertain of the effectiveness of spinal cord stimulators, but because their implantation is listed on the Medicare Benefits Schedule and the devices are approved for reimbursement by the government, insurers are forced to fund their use.
Industry influence
If the evidence suggests no sustained benefit over placebo, the harms are significant and the cost is high, why are spinal cord stimulators being used so commonly in Australia? In New Zealand, for example, the devices are rarely used.
Doctors who implant spinal cord stimulators in Australia are well remunerated and funding arrangements are different in New Zealand. But the main reason behind the lack of use in New Zealand is because pain specialists there are not convinced of their effectiveness.
In Australia and elsewhere, the use of spinal cord stimulators is heavily promoted by the pain specialists who implant them, and the device manufacturers, often in unison. The tactics used by the spinal cord stimulator device industry to protect profits have been compared to tactics used by the tobacco industry.
A 2023 paper describes these tactics which include flooding the scientific literature with industry-funded research, undermining unfavourable independent research, and attacking the credibility of those who raise concerns about the devices.
It’s not all bad news
Many who suffer from chronic pain may feel disillusioned after watching the Four Corners report. But it’s not all bad news. Australia happens to be home to some of the world’s top back pain researchers who are working on safe, effective therapies.
New approaches such as sensorimotor retraining, which includes reassurance and encouragement to increase patients’ activity levels, cognitive functional therapy, which targets unhelpful pain-related thinking and behaviour, and old approaches such as exercise, have recently shown benefits in robust clinical research.
If we were to remove funding for expensive, harmful and ineffective treatments, more funding could be directed towards effective ones.
Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney; Adrian C Traeger, Research Fellow, Institute for Musculoskeletal Health, University of Sydney, and Caitlin Jones, Postdoctoral Research Associate in Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Eat to Your Heart’s Content – by Dr. Sat Bains
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Making food heart-healthy and tasty is a challenge that vexes many, but it doesn’t have to be so difficult.
Dr. Sat Bains, a professional chef with multiple Michelin stars to his name, is an expert on “tasty”, and after surviving a heart attack himself, he’s become an expert on “heart-healthy” since then.
The book contains not only the recipes (of which there are 68, by the way), but also large sections of explanation of what makes various ingredients or methods heart-healthy or heart-unhealthy.
There’s science in there too, and these sections were written under the guidance of Dr. Neil Williams, a lecturer in physiology and nutrition.
You may be wondering as to why the author himself has a doctorate too; in fact he has three, none of which are relevant:
- Doctor of Arts
- Doctor of Laws
- Doctor of Hospitality (Honorary)
…but we prefix “Dr.” when people are that and he is that. The expertise we’re getting here though is really his culinary skill and extracurricular heart-healthy learning, plus Dr. Williams’ actual professional health guidance.
Bottom line: if you’d like heart-healthy recipes with restaurant-level glamour, this book is a fine choice.
Click here to check out Eat To Your Heart’s Content, and look after yours!
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Stop Trying To Lose Weight (And Do This Instead)
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“Lose weight” is a common goal of many people, and it’s especially a common goal handed down from medical authority figures, often as a manner of “kicking the can down the road” with regard to the doctor actually having to do some work. “Lose 20 pounds and then we’ll talk”, etc.
The thing is, it’s often not a very good or helpful goal… Even if it would be healthy for a given person to lose weight. Instead, biochemist Jessie Inchauspé argues, one should set a directly health-giving goal instead, and let any weight loss, if the body agrees it is appropriate, be a by-product of that
She recommends focusing on metabolic health, specifically, her own specialism is blood glucose maintenance. This is something that diabetics deal with (to one degree or another) every day, but it’s something whose importance should not be underestimated for non-diabetics too.
Keep our blood sugar levels healthy, she says, and a lot of the rest of good health will fall into place by itself—precisely because we’re not constantly sabotaging our body (first the pancreas and liver, then the rest of the body like dominoes).
To that end, she offers a multitude of “hacks” that really work.
Her magnum opus, “Glucose Revolution“, explains the science in great detail and does it very well! Not to be mistaken for her shorter, simpler, and entirely pragmatic “do this, then this”-style book, “The Glucose Goddess Method”, which is also great, but doesn’t go into the science more than absolutely necessary; it’s more for the “I’ll trust you; just tell me what I need to know” crowd.
In her own words:
Click Here If The Embedded Video Doesn’t Load Automatically!
Prefer text?
We’ve covered Inchauspé’s top 10 recommended hacks here:
10 Ways To Balance Blood Sugars
Enjoy!
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Lime-Charred Cauliflower Popcorn
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Called “popcorn” for its appearance and tasty-snackness, this one otherwise bears little relation to the usual movie theater snack, and it’s both tastier and healthier. All that said, it can be eaten on its own as a snack (even with a movie, if you so wish), or served as one part of a many-dish banquet, or (this writer’s favorite) as a delicious appetizer that also puts down a healthy bed of fiber ready for the main course to follow it.
You will need
- 1 cauliflower, cut into small (popcorn-sized) florets
- 2 tbsp extra virgin olive oil
- 1 tbsp lime pickle
- 1 tsp cumin seeds
- 1 tsp smoked paprika
- 1 tsp chili flakes
- 1 tsp black pepper, coarse ground
- ½ tsp ground turmeric
Method
(we suggest you read everything at least once before doing anything)
1) Preheat your oven as hot as it will go
2) Mix all the ingredients in a small bowl except the cauliflower, to form a marinade
3) Drizzle the marinade over the cauliflower in a larger bowl (i.e. big enough for the cauliflower), and mix well until the cauliflower is entirely, or at least almost entirely, coated. Yes, it’s not a lot of marinade but unless you picked a truly huge cauliflower, the proportions we gave will be enough, and you want the end result to be crisp, not dripping.
4) Spread the marinaded cauliflower florets out on a baking tray lined with baking paper. Put it in the oven on the middle shelf, so it doesn’t cook unevenly, but keeping the temperature as high as it goes.
5) When it is charred and crispy golden, it’s done—this should take about 20 minutes, but we’ll say ±5 minutes depending on your oven, so do check on it periodically—and time to serve (it is best enjoyed warm).
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- We must do a main feature on the merits of cruciferous vegetables! Watch this space.
- All About Olive Oils (Extra Virgin & Otherwise)
- Capsaicin For Weight Loss And Against Inflammation
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Why Curcumin (Turmeric) Is Worth Its Weight In Gold
Take care!
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The Art of Being Unflappable (Tricks For Daily Life)
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The Art of Being Unflappable
From Stoicism to CBT, thinkers through the ages have sought the unflappable life.
Today, in true 10almonds fashion, we’re going to distil it down to some concentrated essentials that we can all apply in our daily lives:
Most Common/Impactful Cognitive Distortions To Catch (And Thus Avoid)
These are like the rhetorical fallacies with which you might be familiar (ad hominem, no true Scotsman, begging the question, tu quoque, straw man, etc), but are about what goes on between your own ears, pertaining to your own life.
If we learn about them and how to recognize them, however, we can catch them before they sabotage us, and remain “unflappable” in situations that could otherwise turn disastrous.
Let’s take a look at a few:
Catastrophizing / Crystal Ball
- Distortion: not just blowing something out of proportion, but taking an idea and running with it to its worst possible conclusion. For example, we cook one meal that’s a “miss” and conclude we are a terrible cook, and in fact for this reason a terrible housewife/mother/friend/etc, and for this reason everyone will probably abandon us and would be right to do so
- Reality: by tomorrow, you’ll probably be the only one who even remembers it happened
Mind Reading
- Distortion: attributing motivations that may or may not be there, and making assumptions about other people’s thoughts/feelings. An example is the joke about two partners’ diary entries; one is long and full of feelings about how the other is surely dissatisfied in their marriage, has been acting “off” with them all day, is closed and distant, probably wants to divorce, may be having an affair and is wondering which way to jump, and/or is just wondering how to break the news—the other partner’s diary entry is short, and reads “motorcycle won’t start; can’t figure out why”
- Reality: sometimes, asking open questions is better than guessing, and much better than assuming!
All-or-Nothing Thinking / Disqualifying the Positive / Magnifying the Negative
- Distortion: having a negative bias that not only finds a cloud in every silver lining, but stretches it out so that it’s all that we can see. In a relationship, this might mean that one argument makes us feel like our relationship is nothing but strife. In life in general, it may lead us to feel like we are “naturally unlucky”.
- Reality: those negative things wouldn’t even register as negative to us if there weren’t a commensurate positive we’ve experienced to hold them in contrast against. So, find and remember that positive too.
For brevity, we put a spotlight on (and in some cases, clumped together) the ones we think have the most bang-for-buck to know about, but there are many more.
So for the curious, here’s some further reading:
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You Are the One You’ve Been Waiting For – by Dr. Richard Schwartz
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As self-therapy approaches go, the title here could be read two ways: as pop-psychology fluff, or a suggestion of something deeper. And, while written in a way to make it accessible to all, we’re happy to report the content consists of serious therapeutic ideas, presented clearly.
Internal Family Systems (IFS) is a large, internationally recognized, and popular therapeutic approach. It’s also an approach that lends itself quite well to self-therapy, as this book illustrates.
Dr. Schwartz kicks off by explaining not IFS, but the problem that it solves… We (most of us, anyway) have over the course of our lives tried to plug the gaps in our own unmet psychological needs. And, that can cause resentment, strain, and can even be taken out on others if we’re not careful.
The real meat of the book, however, is in its illustrative explanations of how IFS works, and can be applied by an individual. The goal is to recognize all the parts that make us who we are, understand what they need in order to be at peace, and give them that. Spoiler: most what they will need is just being adequately heard, rather than locked in a box untended.
One of the benefits of using this book for self-therapy, of course, is that it requires a lot less vulnerability with a third party.
But, speaking of which, what of these intimate relationships the subtitle of the book referenced? Mostly the benefits to such come from a “put your own oxygen mask on first” angle… but the book does also cover discussions between intimate partners, and approaches to love, including what the author calls “courageous love”.
Bottom line: this is a great book if you want to do some “spring-cleaning of the soul” and live a little more lightly as a result.
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